Assessment of relationship between red blood cell distribution width and renal function in patients with acute heart failure

Document Type : original articles

Authors

Department of Cardiology, Seyyed Al-Shohada Hospital, Urmia University of Medical Sciences, Urmia, Iran

Abstract

Objectives: To investigate the association between Red Blood Cell Distribution Width (RDW) and renal function in patients experiencing acute decompensated heart failure (ADHF).

Methods: A retrospective analysis was conducted on the medical records of 254 patients admitted to Seyyed Al-Shohada Hospital in Urmia, Iran, between July 2021 and July 2023. Patients' RDW values and Glomerular Filtration Rate (GFR) were analyzed using statistical methods.

Results: The study revealed a significant inverse relationship between RDW and GFR. Patients with elevated RDW levels (greater than 14.5%) demonstrated reduced GFR values compared to those with lower RDW levels. The mean GFR in patients with RDW ≤14.5% was 59.31 ml/min, while in patients with RDW >14.5% it was 49.71 ml/min (p < 0.001).

Conclusions: RDW is an important biomarker for evaluating renal function and predicting outcomes in ADHF patients. RDW inclusion in evaluating ADHF patients could improve risk stratification and facilitate early intervention. Additional studies are necessary to validate these findings and examine the underlying mechanisms. RDW Integration into routine clinical practice may enhance the identification of patients at higher risk for renal complications, enabling timely therapeutic interventions and potentially improving overall patient management and outcomes.

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References

1.Ponikowski P, Voors AA,  Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-2200.
2.Ahmadi A, Soori H, Mobasheri M, et al. Heart failure, the outcomes, predictive and related factors in Iran. J Mazandaran Univ Med Sci. 2014; 24(118):180-188.
3.Groenewegen A, Rutten FH, Mosterd A, et al. Epidemiology of heart failure. Eur J Heart Fail. 2020; 22(8): 1342-1356.
4.Ruggenenti P, Remuzzi G. Worsening kidney function in decompensated heart failure: treat the heart, don't mind the kidney. Eur Heart J. 2011; 32(20):2476-2478.
5.Damman K, Valente MA, Voors AA, et al. Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis. Eur Heart J. 2014;35(7):455-469.
6.Beldhuis IE, Streng KW, Ter Maaten JM, et al. Renin–angiotensin system inhibition, worsening renal function, and outcome in heart failure patients with reduced and preserved ejection fraction: a meta-analysis of published study data. Circ Heart Fail. 2017;10(2):e003588.
7.Givertz MM, Postmus D, Hillege HL, et al. Renal function trajectories and clinical outcomes in acute heart failure. Circ Heart Fail. 2014; 7(1):59-67.
8.Evans TC, Jehle D.The red blood cell distribution width. J Emerg Med.1991; 9: 71-74.
9.Aslan D, Gümrük F, Gürgey A, et al. Importance of RDW value in differential diagnosis of hypochrome anemias. Am J Hematol. 2002;69(1):31-33.
10.Tonelli M, Sacks F, Arnold M, et al. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation.2008;117(2):163-168.
11.Yao J, Lv G. Association between red cell distribution width and acute pancreatitis: a cross-sectional study. BMJ open. 2014;4(8):e004721.
12.Salvagno G L, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52 (2):86-105.
13.Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015; 7(10): E402-11.
14.van Kimmenade RR, Mohammed AA, Uthamalingam S, et al. Red blood cell distribution width and 1‐ year mortality in acute heart failure. Eur J Heart Fail. 2010; 12(2):129-136.
15.Núñez J, Núñez E, Rizopoulos D, et al. Red blood cell distribution width is longitudinally associated with mortality and anemia in heart failure patients. Circ J. 2014;78(2):410-418.
16.HuangY-L, Hu ZD, Liu SJ, et al. Prognostic value of red blood cell distribution width for patients with heart failure: a systematic review and meta-analysis of cohort studies. PLoS One. 2014;9(8):e104861.
17.Perlstein TS, Weuve J, Pfeffer MA, et al. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med. 2009;169 (6):588-594.
18.Patel HH, Patel HR, Higgins JM. Modulation of red blood cell population dynamics is a fundamental homeostatic response to disease. Am J Hematol. 2015;90(5):422-428.
19.Uemura Y, Shibata R, Takemoto K, et al. Elevation of red blood cell distribution width during hospitalization predicts mortality in patients with acute  decompensated heart failure. J Cardiol. 2016; 67(3):268-273.
20.Cheng YL, Cheng HM, Huang WM, et al. Red cell distribution width and the risk of mortality in patients with acute heart failure with or without cardiorenal anemia syndrome. Am J Cardiol. 2016; 117(3): 399-403.
21.Yamada T, Ueyama H, Chopra N, et al. Systematic review of the association between worsening renal function and mortality in patients with acute decompensated heart failure. Kidney Int Rep. 2020;5(9):1486-1494.
22.Patel RB, Fonarow GC, Greene SJ, et al. Kidney Function and Outcomes in Patients Hospitalized With Heart Failure. J Am Coll Cardiol. 2021;78(4):330-343.
23.Beldhuis IE, Streng KW, van der Meer P, et al. Trajectories of changes in renal function in patients with acute heart failure. J Card Fail. 2019;25(11):866-874.
24.Xanthopoulos A, Giamouzis G, Dimos A, et al. Red Blood Cell Distribution Width in Heart Failure: Pathophysiology, Prognostic Role, Controversies and Dilemmas. J Clin Med. 2022;11(7):1951.
25.Mucsi I, Ujszaszi A, Czira ME, et al. Red cell distribution width is associated with mortality in kidney transplant recipients. Int Urol Nephrol. 2014;46(3):641-651.
26.Salvagno GL, Sanchis- Gomar F, Picanza A, et al. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52 (2):86-105.
27.Lippi G, Turcato G, Cervellin G, et al. Red blood cell distribution width in heart failure: A narrative review.World J Cardiol. 2018;10(2):6-14.
28.Hu Y, Liu H, Fu S, et al. Red Blood Cell Distribution Width is an Independent Predictor of AKI and Mortality in Patients in the Coronary Care Unit. Kidney Blood Press Res. 2017;42(6):1193-1204.
29.Churpek MM, Snyder A, Sokol S, et al. Investigating the Impact of Different Suspicion of Infection Criteria on the Accuracy of Quick Sepsis-Related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores. Crit Care Med. 2017;45(11):1805-1812.
Cardiovascular Biomedicine
Volume 4, Issue 2
December 2024
Pages 30-37

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History

  • Receive Date: 27 October 2024
  • Revise Date: 15 January 2025
  • Accept Date: 18 January 2025

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